A 21-year-old Iraqi woman presented with a 10-year history of progressive pigmentation of her hands, feet, and face, with sparing of the trunk. The condition was entirely asymptomatic but caused psychological distress, prompting her to cover the areas with clothing.
Physical examination showed finely reticulated, slightly atrophic, hyperpigmented macules, with intervening normal-appearing epidermis, on her face and neck and on the dorsal surface of her hands and feet. She had no palmar or plantar pits (Figure 1 and Figure 2).
Anderson BE, Miller JJ, Mackley CL, Ioffreda MD. A 21-Year-Old Woman With Progressive Reticulated Pigmentation of the Extremities—Quiz Case. Arch Dermatol. 2003;139(5):657-662. doi:10.1001/archderm.139.5.657-a